Conditions

Definition

Focal segmental glomerulosclerosis is scar tissue that forms in parts of the kidney called glomeruli. The glomeruli serve as filters, helping rid the body of unnecessary or harmful substances. Each kidney has thousands of glomeruli. One glomeruli is called a glomerulus.

“Focal” means that some of the glomeruli become scarred, while others remain normal. “Segmental” means that only part of an individual glomerulus is damaged.

Alternative Names

Segmental glomerulosclerosis; Focal sclerosis with hyalinosis

Causes, incidence, and risk factors

The cause of focal segmental glomerulosclerosis is usually unknown.

The condition affects both children and adults. Men and boys are affected slightly more often than women and girls, and it also occurs more often in African Americans. Focal segmental glomerulosclerosis causes about 20 – 25% of all cases of nephrotic syndrome.

Known causes include:

Heroin use

HIV

Inherited genetic problems

Obesity

Reflux nephropathy (a condition in which urine flows backward from the bladder to the kidney)

Sickle cell disease

Symptoms

Foamy urine (from excess protein in the urine)

Poor appetite

Swelling, called generalized edema, from fluids held in the body

Weight gain

Signs and tests

The health care provider will perform a physical examination. This may detect tissue swelling and high blood pressure. Signs of kidney (renal) failure and excess fluid may develop as the condition gets worse.

Tests may include:

Kidney biopsy

Kidney function tests (blood and urine)

Urinalysis

Urine microscopy

Urine protein

Treatment

Some patients will receive high doses of corticosteroids or a drug called cyclosporine to suppress their immune system.

The goal of treatment is to control the symptoms of nephrotic syndrome and prevent chronic kidney failure.

See also:

Chronic kidney failure

Nephrotic syndrome

In general, treatments may include:

Antibiotics to control infections

Anti-inflammatory medicines to reduce the immune response

Dialysis

Fluid restriction

Kidney transplant

Low-fat diet

Low- or moderate-protein diet (1 gram of protein per kilogram of body weight per day)

Medicines to treat high blood pressure, high blood cholesterol, and high triglyceride levels

Salt-reduced diet

Vitamin D supplements

See also: Kidney disease – diet

Expectations (prognosis)

More than half of those with focal or segmental glomerulosclerosis develop chronic kidney failure within 10 years.

Complications

Chronic kidney failure

End-stage kidney disease

Infection

Malnutrition

Nephrotic syndrome

Calling your health care provider

You should call your doctor if you develop symptoms of this condition, especially if there is fever, pain with urination, or decreased urine output.